ArticleEuropean journal of neurology2024
Twenty years on from the introduction of the high risk strategy for stroke and cardiovascular disease prevention: a systematic scoping review.
Article in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 13 citations in OpenAlex.
- Burden of stroke and its subtypes in young adults in Asia, 1990-2021: risk factors and future predictions.Stroke and vascular neurology · 2026Review
- Longitudinal trajectories of stroke risk among Chinese adults: a four-year community screening cohort study.BMC public health · 2026Article
- Association between the combined c-reactive protein-triglyceride glucose index and hypertension with long-term stroke among cardiovascular-kidney-metabolic syndrome stages 0-3 population: a nationwide prospective cohort study.Cardiovascular diabetology · 2026Article
- Attributable risk and time trend in hemorrhagic and ischemic stroke mortality due to high sodium intake in Zhenjiang City from 2010 to 2021: an Age-Period-Cohort (APC) analysis.Frontiers in stroke · 2026Article
- Stroke Action Plan for Europe 2018-2030 (SAP-E): mid-term review and update.European stroke journal · 2026Review
- Global burden of disease analysis of stroke due to high systolic blood pressure in different regions, 1990-2021.BMC public health · 2025Article
- The burden of atherosclerotic cardiovascular disease among working-age people across SDI regions: an age-period-cohort study based on the GBD 2021.Frontiers in cardiovascular medicine · 2025Article
- Comparative analysis of different stroke subtype burden and future trends over 15 years in China and globally from 1990 to 2021.Frontiers in neurology · 2025Article
- Article
- The Impact of Self-Perceived Burden on Loneliness in Stroke Patients: The Mediating Role of Rumination.Patient related outcome measures · 2025Article
- Global, regional, and national burden of stroke and its risk factors, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021.The Lancet. Neurology · 2024Article
- Twenty years on from the introduction of the high risk strategy for stroke and cardiovascular disease prevention: a systematic scoping review.European journal of neurology · 2024Article
Corrections and comments
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Authors and funding
11 authors at 9 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeEarly this century, the high risk strategy of primary stroke and cardiovascular disease (CVD) prevention for individuals shifted away from identifying (and treating, as appropriate) all at-risk individuals towards identifying and treating individuals who exceed arbitrary thresholds of absolute CVD risk. The public health impact of this strategy is uncertain.
methodsIn our systematic scoping review, the electronic databases (Scopus, MEDLINE, Embase, Google Scholar, Cochrane Library) were searched to identify and appraise publications related to primary CVD/stroke prevention strategies and their effectiveness published in any language from January 1990 to August 2023.
resultsNo published randomized controlled trial was found on the effectiveness of the high CVD risk strategy for primary stroke/CVD prevention. Targeting high CVD risk individuals excludes a large proportion of the population from effective blood-pressure-lowering and lipid-lowering treatment and effective CVD prevention. There is also evidence that blood pressure lowering and lipid lowering are beneficial irrespective of blood pressure and cholesterol levels and irrespective of absolute CVD risk and that risk-stratified pharmacological management of blood pressure and lipids to only high CVD risk individuals leads to significant underuse of blood-pressure-lowering and lipid-lowering medications in individuals otherwise eligible for such treatment.
conclusionsPrimary stroke and CVD prevention needs to be done in all individuals with increased risk of CVD/stroke. Pharmacological management of blood pressure and blood cholesterol should not be solely based on the high CVD risk treatment thresholds. International guidelines and global strategies for primary CVD/stroke prevention need to be revised.
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